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Elderly parents

Paying for care advice please

11 replies

JaceLancs · 13/11/2018 18:32

My 92 year old Dad had a massive stroke 4 weeks ago, he is unable to speak or swallow and is paralysed down one side, cognition hard to determine, currently still in hospital assessed as needing nursing care as he is unable to stay in a stable position for more than 90 minutes and cannot self position at all
First of all we were told that he would probably be eligible for CHC or nursing care element although has not been assessed by anyone as they use a discharge to assess pathway system and we objected as the places suggested were unsuitable and deemed unsafe (recent CQC)
Now as he is improving very slightly we have been told that we need to find him a nursing home and he will get community rehab - however whilst he is getting rehab he can’t be assessed for CHC so will have to pay in full
Mum has dementia and whilst still living in sheltered housing can manage at moment with our help
They don’t own home but do have savings, pensions etc
Will her income and savings be taken into account? As well as his, because at some point she will also need help, doesn’t seem fair if that is the case
Myself and sibling have LPA on both care and finance as neither have capacity
Any good resources or websites I can get advice from
What we need to ensure is they both get the help they need for as long as possible eg don’t want to move Dad to expensive nursing care and then have to move him again when he runs out of money potentially also leaving even less care options for Mum when it’s her turn
Ideally they both want him to return home with a package of care for both, but we’ve been told he has to improve to be safe between care visits of 3-4 hours and that may take a long time or never be achievable
Apologies for the essay

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florentina1 · 13/11/2018 19:01

For accurate advice I would consult the AGEUK website. This is so clear and gives the latest figures. If there is anything that is not clear or unique to your situation you can phone them. They are very kind and helpful. So kind, in fact, that I ended up sobbing in gratitude down the phone.

This is what I remember , but cannot vouch for absolute accuracy.
Each person is assessed separately and can have about £23000 in saving before you have to pay. If they go into care then any srare pension that they get are used but Only half of private pension is. I would check that with AGEUK. This is because the spouce still has bills to pay.

If your Dad goes into care and your mum has a diagnosis then she should get free or reduced community charge, check with your LA. Are they getting Attendance Allowance. This will stop for your dad if he goes into care but may increase for your mum to the higher rate. It is worth checking.

The assessment should be done in hospital and some LAs will pay for 6 weeks respite care. Respite care should Include PT. I have found the PTs very helpful in fighting your case for nursing care. They cannot speak for you but will give you the information you need to make a case.

Don’t be afraid to, ask for a case meeting, so that all professionals involved can be heard. Also don’t be fobbed off by those trying to free up a bed. Using the phrase, “He is a vulnerable adult and ‘they’ need to assure you that he is being released into a safe environment”, is a great phrase to use. (Told to me by Mum’s GP)

There is an elderly parents thread on here which is an absolute life saver. Full of kind and knowledgeable people going through the same thing.

If you are not already doing so, get their post redirected to you. that way you can deal with appointments and business matters. It is not unknown for hospitals to phone Alzheimer’s patients to tell them of a change of appointment and then act surprised when they show up on the wrong day.

thesandwich · 13/11/2018 19:24

Excellent advice from florentina- age uk or carers association are really helpful.
Do push for chc assessment - have a look at the checklist. And the main elderlies thread is really helpful.good luck.

JaceLancs · 13/11/2018 21:50

Thank you - will also check out the main thread

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hatgirl · 13/11/2018 22:34

If you google 'your local authority name residential care' charging the council will have put their guidance online.

However the basics are over £23k in savings in your dads name he will pay full whack, anything under that and he will pay on a sliding scale downwards.

HOWEVER

DO NOT LET HIM BE DISCHARGED FROM HOSPITAL WITHOUT A CHC CHECKLIST/ASSESSMENT TAKING PLACE

The point of discharge to assess is to get people needing further assessment out of hospital into secondary care environments rather than taking up acute hospital beds. The NHS pays for these secondary care beds until it is determined whether the person has primarily social care or health needs.

If your father is not being discharged via discharge to assess then he needs to have a full social care assessment before he leaves hospital which should include screening for CHC.

DO NOT LET THEM DISCHARGE HIM FOR 'REHAB' AND MAKE HIM PAY FOR IT UNTIL THEY GET ROUND TO ASSESSING.

If you haven't been assigned a hospital discharge social worker already demand the hospital refers him prior to any decisions being made about his discharge.

thesandwich · 13/11/2018 22:39

Brilliant advice from @hatgirl who knows her stuff.

JaceLancs · 13/11/2018 23:14

Just had an email today saying that discharge to assess will not now be taking place and he will be allocated a SW so will wait to hear from social services (they know I’m away until next week) so will have to wait re financial info and also I’ve asked to be involved in assessment process
I feel bad about bed blocking but only want what is best for him and to make sure no gaps and everything in place etc

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hatgirl · 13/11/2018 23:37

Don't feel bad, the hospital have given you incorrect and borderline unlawful advice at various stages by the sounds of things.

It may be worth giving the ward a list of dates in the near future you will be available for a meeting before you go away so they can get the ball rolling getting all the relevant professionals together for when you get back.

From the limited information you have given I suspect he will definitely trigger for assessment for CHC, and if that's the case then once the social work team have him on their list there is no chance he will be going anywhere without a full assessment for CHC taking place first.

My gut feeling is the hospital has tried to pull a bit of a fast one, don't feel guilty for insisting on proper process being followed and ensuring your father has a safe and well planned discharged. It's your duty as his LPoA after all.

JaceLancs · 19/11/2018 10:45

Update here
Back from holiday now, just had s call from social services as DF has now been allocated a SW
MDT meeting on Friday so have invited SW and then can meet with them after along with DB to discuss what options there are
DF is improving very slightly and slowly but it’s helping me feel more positive

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JaceLancs · 24/11/2018 23:32

Had MDT meeting although he now has a SW they are still insisting on discharging him into a ‘free’ for 28 days nursing home whilst they assess him for CHC - due to his improvements I think he will only be assessed for nursing care element
We have been given 3 options of nursing home who have beds and are LA approved provider (ie within their budget) 1 of which we think is ok but are visiting tomorrow to check out thoroughly
We have been told we must decide which of the 3 by Monday PM and that he will be moved Thursday or Friday
Does this sound right? How can we force them to let him stay in hospital until CHC assessment when they say they won’t do that

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hatgirl · 25/11/2018 09:41

Yes that sounds ok (it actually sounds like discharge to assess??)

If he no longer requires treatment in an acute hospital bed it's fine for them to transfer him elsewhere while he awaits social care/CHC assessment providing they fund it which it sounds like they will for up to 28 days. It's far cheaper for them to fund a nursing home bed temporarily than he takes up an acute hospital bed unnecessarily.

What would have been wrong is if they moved him and made him pay for it prior to all of the assessments he is entitled to taking place.

Presumably they expect to complete all of their assessments within 28 days and at that point he will be advised of his options (stay where he is/go home/go somewhere else etc) and who will be paying for any care and how much.

If he has any care needs at all he still needs to have a continuing health care checklist completed. Often they will do that at the same time as the nursing assessment.

JaceLancs · 25/11/2018 12:05

It is pathway 3 which I think is a version of DTA but in conjunction with social worker
Thanks for help - will update later

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